The Santa Cruz County Diabetes Mellitus Registry project builds on a history of productive collaboration among the County's public, private, and not-for-profit health sectors. Two physician organizations, the County's Medicaid HMO, the health department, a local community college, and a local philanthropy form the project team. The clinical entities have agreed to share encounter/claim, laboratory, and pharmacy data to populate a County-wide diabetes registry. The registry software was developed by one of the physician groups, whose Medical Director will serve as the project's principal investigator. The existing registry is Web-based and interactive, giving physicians and their colleagues many options for improving the standard of diabetes care provided to patients. Prompts can remind physicians and medical assistants about needed tests at the point of care; the registry also can generate lists of patients overdue for exams or tests so that medical office staff can accelerate the appointment process. Because most of the data are captured electronically, the registry is populated with minimal burden within the office itself. Patients who change providers or health care plans can do so without losing their extensive histories of diabetes care; likewise, their providers potentially have immediate access to useful, accurate, and up-to-date information about their patients. The immediate goal of the Santa Cruz DMR project is to extend the existing registry to as many County providers as possible. This will be accomplished in phases, by customizing training, reaching agreements among the organizations about sharing data, and piloting and launching the registry in increments. This, in turn, will make it possible not only to improve the level of diabetes care within individual offices, but to make a higher standard of care consistent across the County. In addition, the registry will make it possible to track the County's diabetes population in the aggregate, to identify trends in key indicators of care and control of this preventable but potentially devastating - and costly - disease. [unreadable] [unreadable]